Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA, Department of Neurology, University of Washington, Seattle, WA, USA.
Epileptic Disord. 2020 Dec 1;22(6):782-789. doi: 10.1684/epd.2020.1229.
There is limited information on disparities of people with epilepsy (PWE) and, foremost, their caregivers. The objective of this study was to comprehensively compare between PWE and caregivers with low socioeconomic status (SES) and those with high SES for disparities in demographic and epilepsy characteristics, treatment and health care utilization, physical and psychosocial impact, and knowledge about epilepsy. PWE and caregivers completed surveys about the aforementioned outcomes during their epilepsy clinic visit or epilepsy monitoring unit admission. Associations were evaluated using SES as a binary independent variable and the patient and caregiver related outcomes as dependent variables. Thirty-eight patients with low SES and 88 patients with high SES were recruited. Patients with low SES were more commonly non-white, uninsured, unemployed, of lower educational attainment and living in larger households. They were more likely to visit the emergency room for their seizures, were more frequently on polypharmacy and experienced more AED adverse effects. They exhibited higher depression and anxiety levels and worse quality of life. Twenty-two caregivers with low SES and 66 caregivers of high SAS were recruited. Caregivers with low SES were more likely to be non-white and single. They manifested poorer knowledge about epilepsy. There are notable inequalities in demographic, treatment-related and health care utilization aspects of care of PWE, as well as in the psychosocial impact of their disease. Additional demographic and epilepsy knowledge-related disparities are recognized in caregivers of PWE. Identification of those disparities is a critical step in the creation of appropriate interventions to eliminate them.
有关癫痫患者(PWE)及其护理人员的差异信息有限,尤其是他们的护理人员。本研究的目的是全面比较社会经济地位(SES)较低和较高的 PWE 和护理人员在人口统计学和癫痫特征、治疗和医疗保健利用、身体和心理社会影响以及对癫痫的认识方面的差异。PWE 和护理人员在癫痫诊所就诊或癫痫监测单位入院期间完成了上述结果的调查。使用 SES 作为二元自变量和患者和护理人员相关结果作为因变量评估相关性。共招募了 38 名 SES 较低的患者和 88 名 SES 较高的患者。SES 较低的患者更常见为非裔美国人、没有保险、失业、教育程度较低、居住在更大的家庭中。他们更有可能因癫痫发作而去急诊室,更常使用多种药物治疗,并经历更多的 AED 不良反应。他们表现出更高的抑郁和焦虑水平以及更差的生活质量。共招募了 22 名 SES 较低的护理人员和 66 名 SES 较高的护理人员。SES 较低的护理人员更有可能是非裔美国人且单身。他们对癫痫的认识较差。PWE 的护理在人口统计学、治疗相关和医疗保健利用方面存在显著不平等,以及疾病的心理社会影响方面也存在显著不平等。PWE 的护理人员还存在与认知相关的其他差异。确定这些差异是制定适当干预措施以消除这些差异的关键步骤。